Between a rock and a hard place: Prescription opioid restrictions in the time of fentanyl and other street drug adulterants

Abstract

Non-medical prescription opioid use (NMPOU) has increased alarmingly across Canada and resulted in strict prescribing restrictions on opioids. Despite a clear need to reduce opioid prescriptions in response to this crisis, few other policies have been implemented and this singular focus is incongruent with the known characteristics of substance use disorders, negative effects of supply reduction policies, and realities of pain management. Given the recent rise of fentanyl and otherdangerous adulterants in streetdrugs, this commentary argues thatacomprehensive response to NMPOU that includes improvements to addiction management and harm-reduction services is urgently needed.

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